However, meta-analyses have yielded inconsistent conclusions. A meta-analysis of 6 cohort studies and 6 RCTs concluded that current data are not conclusive as to whether statins are protective for CIN [158], while another meta-analysis of data on 1,251 patients from 7 RCTs concluded that periprocedural short-term statin treatment is likely effective in the prevention of CIN [159]. At the present time, we consider not to use statins to prevent CIN. Prevention of Nirogacestat contrast-induced nephropathy: dialysis Does hemodialysis conducted after contrast exposure EPZ 6438 as a measure to prevent CIN decrease the risk for
developing CIN? Answer: Because there is no evidence indicating that hemodialysis decreases the risk for developing CIN, we recommend not to use hemodialysis after contrast exposure for this purpose. Is hemofiltration superior to hemodialysis in decreasing the risk for developing CIN? Answer: We consider not to use hemofiltration
as a measure to prevent CIN. Contrast media can be removed from the blood by hemodialysis. It has been reported that 60–90 % of the contrast medium is removed during 1 session of hemodialysis. Clinical studies have been conducted on the basis of these findings to investigate the efficacy of hemodialysis, hemodiafiltration, and hemofiltration in the prevention of CIN [160–169]. However, most studies could not demonstrate the efficacy of these procedures in the prevention of CIN. A few studies have reported a lower risk of CIN, but some others have reported an increased selleck screening library risk of CIN. The risk of CIN was not changed in a majority of studies. Accordingly, there is no scientific evidence that supports the use of hemodialysis as a measure to prevent CIN. Although studies have been conducted to investigate the efficacy of hemofiltration in preventing CIN, there has been no conclusive evidence that hemofiltration prevents CIN by removing Flavopiridol (Alvocidib) the contrast
medium from the blood. However, in the clinical setting, hemodialysis may be conducted after contrast exposure to prevent heart failure or for other purposes. Treatment of contrast-induced nephropathy Does the treatment of CIN with loop diuretics improve the recovery from AKI? Answer: We recommend not using loop diuretics for the treatment of CIN because it does not improve the recovery from AKI. Most clinical studies on the effects of loop diuretics in the treatment of AKI, including CIN, have concluded that loop diuretics are ineffective in the treatment of AKI [170–174]. In a RCT of 338 patients with AKI requiring dialysis therapy who received either loop diuretics (furosemide) or placebo, furosemide showed no significant improvement for any endpoints tested [173]. In 2 meta-analyses published in 2006 [175] and 2007 [176], loop diuretics were not associated with improved kidney function, rate of hemodialysis, or mortality.